High Visceral Fat on Your DEXA Scan? Your 4 Next Steps

Your DEXA scan came back, and one number stands out: visceral fat. It's the fat you can't see in the mirror, stored deep in your abdomen around your liver, intestines and other organs. An elevated reading is a signal worth acting on, and the good news is that visceral fat is one of the most responsive types of fat to change.

Here's what visceral fat means and the four steps to take next.

Why visceral fat matters

Not all fat behaves the same way. The fat under your skin (subcutaneous fat) is mostly storage. Visceral fat is metabolically active: it releases inflammatory signals and fatty acids that go straight to the liver. Higher visceral fat is linked with insulin resistance, type 2 diabetes, fatty liver disease, high blood pressure and heart disease.

It's also why a normal weight or BMI can be misleading. People with a healthy-looking weight can still carry a high amount of visceral fat. A DEXA scan measures it directly, so you know what you're working with.

Visceral fat isn't just a number on a report. It's a reason to look deeper at your metabolic and heart health.

Step 1: Review your results with your doctor

Bring your DEXA report to your primary care doctor or cardiologist. Visceral fat is one piece of a bigger picture, and your doctor can put it in context with your blood pressure, family history, medications and other risk factors.

• Bring: your full DEXA report, including visceral fat, body fat percentage and lean mass.
• Share: any family history of heart attack, stroke or diabetes, especially at a young age.
• Ask: "Given my visceral fat, which blood tests should we run, and how often should I recheck?"

Step 2: Start an exercise program

Visceral fat responds well to exercise, often even before the scale moves much. The most effective programs combine two types of training:

• Aerobic exercise: aim for at least 150 minutes a week of moderate activity, such as brisk walking, cycling or swimming, or a mix of moderate and vigorous effort.
• Strength training: at least two days a week. Building muscle improves how your body handles blood sugar, and more lean mass means a higher resting metabolism.
• Move more every day: short walks after meals help control blood sugar.

If you're new to exercise or have a heart condition, get your doctor's okay first, and consider working with a coach who can progress your program safely.

Step 3: Improve your nutrition

You don't need an extreme diet. Consistent, simple changes make the biggest difference:

• Cut back on added sugars and refined carbohydrates, especially sugary drinks, which are closely linked to visceral fat.
• Prioritize protein at every meal to protect muscle while you lose fat.
• Eat more fiber from vegetables, beans, whole grains and fruit.
• Limit alcohol, which tends to be stored as abdominal fat.
• Protect your sleep and manage stress. Poor sleep and chronic stress both make visceral fat harder to lose.

A registered dietitian can build a plan around your preferences and any health conditions.

Step 4: Get a comprehensive blood panel

Elevated visceral fat is a reason to look under the hood. A basic cholesterol test doesn't tell the whole story. Ask your doctor for a comprehensive panel that includes:

What is Lp(a)?

Lipoprotein(a), usually written Lp(a) and pronounced "L-P-little-a," is a particle similar to LDL cholesterol with an extra protein attached, called apolipoprotein(a). That extra protein makes it stickier and more likely to contribute to plaque and blood clots.

Your Lp(a) level is largely determined by your genes, so diet and exercise change it very little. That's exactly why it matters: someone can eat well, exercise and have normal LDL cholesterol yet still carry an inherited risk they don't know about. Because it stays fairly stable over a lifetime, many experts recommend testing it at least once. Knowing your number helps you and your doctor decide how aggressively to manage your other risk factors.

For a deeper explanation, listen to cardiologist Dr. Michael Twyman on the Dhru Purohit Show, where he covers why Lp(a) is making headlines, what new drug trials have shown, optimal levels and how to test: Everyone Is Talking About Lp(a): What It Means for Your Heart and What to Do If Yours Is High.

What is ApoB?

Apolipoprotein B, or ApoB (sometimes called "Lipo B"), is a protein found on every particle that can carry cholesterol into your artery walls, including LDL and Lp(a). Each of those particles carries exactly one ApoB, so an ApoB test is essentially a count of the particles that can cause plaque.

Why does that matter? Two people can have the same LDL cholesterol number but very different numbers of particles. The person with more particles generally has higher risk. That's why many cardiologists now consider ApoB a more precise measure of risk than LDL cholesterol alone, especially for people with visceral fat, insulin resistance or high triglycerides.

Watch this short explanation:

Can't see the video? Watch it on YouTube.

Our recommendation: the ClearCardio Proof Program

If your visceral fat is elevated, or if your blood work shows high Lp(a) or ApoB, the next question is whether plaque has already started to form in your arteries. Blood tests show risk. Imaging shows what's actually there.

That's where traditional testing can fall short. A stress test mainly catches blockages that are already narrowing an artery enough to limit blood flow. Much of the plaque behind heart attacks is softer, earlier-stage plaque that a stress test can miss. AI-powered cardiac CT (CCTA) is designed to find and measure that plaque directly, often long before any symptoms.

The ClearCardio Proof Program, led by Harvard-trained cardiologist Dr. John Osborne, starts with comprehensive testing and then gives you an 18-month program to get your heart health back on track.

• Comprehensive testing: CCTA imaging with AI analysis to directly measure coronary plaque, advanced bloodwork, Heart-Lung AI screening and full-body DEXA imaging.
• An 18-month program: a physician-guided plan with regular check-ins and ongoing PulseScore™ tracking, so you can see how your plaque, visceral fat and other markers change over time.
• Pricing: the program starts at $5,000.

The goal is objective data at every step: understand your cardiovascular risk, act on it, and prove what's working.

Book a consult with a ClearCardio cardiologist

Prefer to start with a DEXA scan at a ClearCardio location? Find a ClearCardio location.

Retest to see your progress

The best part about visceral fat is that it can change. Recheck with a DEXA scan every 8 to 12 weeks while you're working on it, so you can see whether your exercise and nutrition changes are reducing visceral fat while protecting your muscle.